title: Neo-modified Koyanagi technique for the single-stage repair of proximal hypospadias.
abstract: OBJECTIVE
  To retrospectively analyze the results of a modification of the Koyanagi hypospadias repair developed to reduce complications.
  
  
  METHODS
  Twelve boys underwent a modified Koyanagi repair over the past 3 years. The technique included the preservation of a wide vascular pedicle for each parameatal flap. The distal urethral plate was left intact and attached on each lateral side to the medial side of each distal Koyanagi pedicle flap.
  
  
  RESULTS
  One boy (8%) developed a urethral fistula. There was no instance of meatal stenosis, sacculation or urethral stricture.
  
  
  CONCLUSIONS
  Modifying the Koyanagi repair by preserving a wide vascular pedicle for the distal skin flaps and utilizing the distal urethral plate as the base for the distal neourethra has lowered the incidence of complications. This technique is a suitable alternative to a two-stage approach for the correction of proximal hypospadias.
authors.affiliation: Department of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. yutaro@med.nagoya-cu.ac.jp
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kojima
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakane
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kurokawa
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Maruyama
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri